The High Diagnostic Accuracy of Combined Test of Thyroid Transcription Factor 1 and Napsin A to Distinguish between Lung Adenocarcinoma and Squamous Cell Carcinoma: A Meta-Analysis

Li, Li; Li, Xiaorong; Yin, Jieyun; Song, Xinying; Chen, Xiaochen; Feng, Jingyi; Gao, Hongyu; Liu, Li; Wei, Sheng

doi:10.1371/journal.pone.0100837

Cited by 16 publications

(10 citation statements)

References 42 publications

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“…The variant adenocarcinoma and poorly differentiated adenocarcinoma had lower expression ratios on CK-7, TTF-1, Napsin-A, and mutant EGFRs when compared to the acinar, papillary, lepidic, and solid patterns. CK-7, TTF-1, Napsin-A, and mutant EGFRs were tissue-specific markers 9 , 22 for well-differentiated lung adenocarcinomas, which were also consistent with the growth patterns. The lepidic pattern had the lowest expression ratio of ALK, while the variant adenocarcinoma had the highest expression ratio of ALK.…”

Section: Discussionsupporting

confidence: 72%

Prognostic implications of immunohistochemistry markers for EGFR-TKI therapy in Chinese patients with advanced lung adenocarcinoma harboring EGFR mutations

Zhang

Yan

Nie

et al. 2016

OTT

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BackgroundEpidermal growth factor receptor (EGFR) mutations in non-small-cell lung cancer predict dramatic clinical responses to tyrosine kinase inhibitor (TKI) treatment. The conclusion on EGFR mutation-specific antibodies by immunohistochemistry (IHC) is not consistent. We evaluated the clinical availability of EGFR mutation-specific antibodies, investigating the prediction role of mutant EGFRs and other IHC markers in TKI therapy in patients with advanced lung adenocarcinoma.Materials and methodsWe analyzed 637 primary lung adenocarcinomas from an unselected Chinese population. For IHC, antibodies against EGFR exon 19 E746_A750 deletions, exon 21 L858R mutations, thyroid transcription factor-1 (TTF-1), and Napsin-A were applied. Positivity was defined as staining score >0.ResultsSpecificities of E746_A750 and L858R antibodies were 99.6% and 99.3%, while sensitivities were 86.0% and 82.7%, respectively. Tumors with Napsin-A positivity, TTF-1 positivity, EGFR mutations, and lepidic pattern showed a lower marker of proliferation index (Ki67). Higher expression scores of mutant EGFR protein, TTF-1 positivity, lower Ki67 proliferation index, and lepidic pattern were associated with longer progression-free survival.ConclusionHigh scores of mutant EGFR, Napsin-A positivity, TTF-1 positivity, lower Ki67 index, and lepidic pattern were favorable predictors for TKI therapy in patients with advanced lung adenocarcinoma.

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Section: Discussionsupporting

confidence: 72%

Prognostic implications of immunohistochemistry markers for EGFR-TKI therapy in Chinese patients with advanced lung adenocarcinoma harboring EGFR mutations

Zhang

Yan

Nie

et al. 2016

OTT

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“…The potentially curative and/or palliative therapy for irresectable lung cancer has evolved significantly over the past 2 decades and, with the availability of targeted therapies that require a precise sub‐typing of NCSLC, further epigenetic testing has become paramount. Distinguishing adenocarcinoma and large cell carcinoma from squamous cell carcinomas is the first step in this focussed approach …”

Section: Introductionmentioning

confidence: 99%

“…Distinguishing adenocarcinoma and large cell carcinoma from squamous cell carcinomas is the first step in this focussed approach. 3 Several investigators have utilised a combination of immunocytochemistry including dual or triple marker for subtyping NSCLC and reported varying sensitivities and specificities. 4 The combination of thyroid transcription factor 1 (TTF-1) and napsin A has been considered a promising tool to subclassify NSCLC in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The utility of TTF‐1, napsin A, CK5 and p63 staining in the sub‐classification of non‐small cell carcinoma of the lung

2019

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Background The potentially curative and/or palliative therapy for non‐resectable lung cancer has evolved significantly over the past 2 decades. With the availability of targeted therapies, the need for precise sub‐typing of non‐small cell lung carcinoma (NCSLC) has become paramount. Objectives As there are few data from South Africa, we aimed to determine utility of TTF‐1, napsin A, p63 and CK5 immunostaining on fine needle aspiration (FNA) cell block and formalin‐fixed paraffin‐embedded tissue biopsy specimens in subtyping NSCLC as adenocarcinoma and squamous cell carcinomas. Methods All cases of NSCLC diagnosed during a 3‐year period were retrospectively identified. All FNA biopsy and formalin‐fixed paraffin‐embedded cases that were stained with TTF‐1, napsin A, CK5 and p63 were collected. A lung cancer registry was used to access and correlate clinical and radiological data. Results We included 271 cases with diagnoses of adenocarcinoma of the lung (n = 201), squamous cell carcinoma of the lung (n = 53), unspecified NSCLC (n = 8) and other carcinomas (n = 9). TTF‐1 and napsin A had sensitivities of 99.0% and 91.9%, respectively, positive predictive values (PPVs) of 90.8% and 90.3%, respectively, and accuracies of 91.0% for adenocarcinoma of the lung. Napsin A had a higher specificity than TTF‐1 (90.2% vs 62.8%). Both CK5 and P63 had high sensitivities (95.4% and 97.9%, respectively) and negative predictive values of 96.4% and 96.8%, respectively, for squamous cell carcinoma of the lung. CK5 had a higher specificity than p63 (84.4% and 61.2%, respectively), PPV (80.4% and 70.8%, respectively) and accuracy (88.8% and 79.2%, respectively) for squamous cell carcinoma. Conclusion All four immunostaining methods had high sensitivities. TTF‐1 and napsin A both had high PPV and diagnostic accuracy for adenocarcinoma of the lung, whereas CK5 had an equally high PPV and accuracy for squamous cell carcinoma of the lung. The specificity of napsin A for adenocarcinoma was higher than that of TTF‐1. The specificity of CK5 for squamous cell carcinoma was higher than p63.

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“…These 2 markers are the most commonly used and represent the most valuable specific immunomarker combination for the diagnosis of lung adenocarcinoma to distinguish between primary and metastatic disease. [ 1 , 2 ] Subsequent computed tomography (CT) of the chest and abdomen showed that the lesion was in the upper left lobe near the hilum of the lung (Fig. 1 A and B).…”

Section: Case Reportmentioning

confidence: 99%

“…Cervical cancer is generally metastatic to the lung via the blood circulation, but metastasis to the uterine cervix from primary lung carcinoma is rarely observed. [ 1 ] Non-small-cell lung cancer (NSCLC) is generally metastatic to the regional lymph nodes, brain, bone, liver, and adrenal gland. The detection of mutations in and site distribution of NSCLC-related genes is particularly important for advanced lung adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

Lung adenocarcinoma with EGFR gene mutation metastatic to the uterine cervix

Wang

Lin²,

Wang

et al. 2020

Medicine

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Introduction: The cervix is a rare site of metastasis from advanced lung adenocarcinoma. Driven gene detection is particularly important for the treatment of advanced lung adenocarcinoma. Patient concerns: A 49-year-old Chinese female was sent to our hospital because of lumbago and sacroiliac joint pain; she was unable to walk and had vaginal bleeding. The following examinations were performed: imaging, colposcopy, bronchoscopy, immunohistochemistry and next-generation sequencing. Diagnosis: According to the clinical manifestations and the examination results, the diagnosis was lung adenocarcinoma with cervical, brain, adrenal gland and bone metastases. More importantly, EGFR gene mutations (del19) were detected in both the primary lung lesion and uterine cervical biopsy specimen. Interventions: Osimertinib was chosen as the first-line treatment. Outcomes: Lumbago and sacroiliac joint pain were significantly relieved. The levels of tumor markers decreased. Primary injuries and metastatic sites were significantly reduced. Conclusion: Physicians should be alert to the signals of vaginal bleeding and consider that primary lung adenocarcinoma may metastasize to the uterine cervix.

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The High Diagnostic Accuracy of Combined Test of Thyroid Transcription Factor 1 and Napsin A to Distinguish between Lung Adenocarcinoma and Squamous Cell Carcinoma: A Meta-Analysis

Cited by 16 publications

References 42 publications

Prognostic implications of immunohistochemistry markers for EGFR-TKI therapy in Chinese patients with advanced lung adenocarcinoma harboring EGFR mutations

Prognostic implications of immunohistochemistry markers for EGFR-TKI therapy in Chinese patients with advanced lung adenocarcinoma harboring EGFR mutations

The utility of TTF‐1, napsin A, CK5 and p63 staining in the sub‐classification of non‐small cell carcinoma of the lung

Lung adenocarcinoma with EGFR gene mutation metastatic to the uterine cervix

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